title: Young adults with spina bifida may have higher occurrence of prehypertension and hypertension.
abstract: OBJECTIVE
  The aims of this study were to determine the occurrence of prehypertension and high blood pressure in adults with spina bifida (SB) and to examine relationships among blood pressure, cardiovascular disease risk factors, and SB-specific factors.
  
  
  METHODS
  This is a cross-sectional, retrospective analysis of adults with SB. SB-specific factors and cardiovascular disease risk factors were compared among subjects with high blood pressure, subjects with blood pressure in the prehypertensive range, and normotensive subjects using the χ, Kruskal-Wallis, or Fisher's exact tests.
  
  
  RESULTS
  Of 225 subjects, the occurrence of prehypertension and high blood pressure was 27% (n = 22) and 27% (n = 22) for ages 18-29 yrs, 35% (n = 26) and 41% (n = 30) for ages 30-39 yrs, 18% (n = 8) and 66% (n = 29) for ages 40-49 yrs, and 21% (n = 5) and 67% (n = 16) for 50 yrs or older, respectively. Of the subjects with high blood pressure, 56% were men, 14% had obstructive sleep apnea, 14% had diabetes, 19% had renal dysfunction, 38% used tobacco, 16% had hydronephrosis, and 71% had a shunt. The groups differed significantly with respect to diabetes (P = 0.004), bladder procedures (P = 0.001), and renal dysfunction (P < 0.001), with higher proportions of subjects with high blood pressure having these comorbidities.
  
  
  CONCLUSIONS
  Fewer than half of the subjects were considered normotensive. A greater proportion of young adults with SB appear to have high blood pressure compared with the general United States population. Because elevated blood pressure is an independent, modifiable risk factor of cardiovascular disease, these findings support early screening and intervention for elevated blood pressure in individuals with SB.
authors.affiliation: From the Department of Physical Medicine and Rehabilitation (BCS, BED) and Adult Outpatient Spina Bifida Clinic (BED), University of Pittsburgh Medical Center, Pennsylvania; Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pennsylvania (BED); Department of Rehabilitation Science and Technology, University of Pittsburgh, Pennsylvania (BED); and Huntersville Pediatrics and Internal Medicine, Huntersville, North Carolina (TSW).
authors.forename: Beth C
authors.initials: BC
authors.lastname: Stepanczuk
authors.forename: Brad E
authors.initials: BE
authors.lastname: Dicianno
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Webb
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058246:Prehypertension / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D012016:Reference Values; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016135:Spinal Dysraphism / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D014481:United States; D055815:Young Adult